“In the course of doing my research, and later as a follow-up, I posted qualitative surveys on the Internet and asked gay men to describe their experiences with drugs, particularly meth, and how the drugs impacted their sexuality, their health, and their relationships. … The response was overwhelming: a total of 637 men from 32 countries and nearly every state in the United States responded. A nerve had been touched. I found that gay men were hungry for someone to whom they could describe their experience with meth, along with their pain and hope. They wrote lengthy, moving, and extremely personal descriptions of their experience with sex and drugs. I was determined to understand and help.”
– David Fawcett

Lust, Men and MethIn 2013, in the second edition of my book, Cruise Control: Understanding Sex Addiction in Gay Men, I included a chapter on the fusion of substances with sexual activity, in particular the tendency of some gay men to pair (or fuse) methamphetamine with sex. Because my book focused primarily on sexual addiction, I did not delve too deeply into the nature of this dual addiction, other than to say that it is double-trouble in terms of relapse (because meth-sex addicts must overcome both drug and sex triggers), and that relapse with one addiction almost inevitably leads to relapse in the other, so both issues need to be addressed concurrently to achieve any type of lasting sobriety.

Since the revision of Cruise Control, meth-sex addiction has become something of an epidemic, especially in the gay community. For evidence, one need look no further than 12-Step sexual recovery meetings frequented by gay men (like SCA, SAA, and SLAA), where a third or more of the newly recovering individuals state that meth is a significant part of their story, and Crystal Meth Anonymous (CMA) meetings frequented by gay men, where we see the flip side of the story (sex as a significant factor in meth use). Either way, meth usage and compulsive sexual behaviors are intertwined for many addicts, with each behavior fueling the other.

Happily, my friend and colleague, Dr. David Fawcett, has published an excellent and comprehensive book on this meth-sex fusion, Lust, Men, and Meth: A Gay Man’s Guide to Sex and Recovery. Fawcett’s work examines all of the latest information on dual meth-sex addictions – compiling, evaluating, and presenting this material in a reader-friendly package that is highly useful to both meth-sex addicts and the clinicians who treat them.

As many readers are aware, books on addiction can, at times, be quite dry and uninteresting. That is not the case here, however, as Fawcett relies on qualitative research and more than 30 years of clinical experience (working mostly with gay men) as a way to bring factual information to life. For instance, he tells readers about a client named Mike, writing:

He was in a near panic about his health. He revealed that he had been treated several times for both syphilis and gonorrhea, and although he still tested negative for the HIV virus, he lived with the constant dread of seroconverting. … He listed other costs extracted by his drug use, including losing his partner of six years as well as his job. He was on the edge of financial disaster and was about to forfeit his house. He then went on to describe an even more devastating consequence of meth use. The fusion of drugs and sex had left him, as he described it, “sexually broken.” He said, “I feel like a sexual cripple.”

I can’t even begin to tell you how many times I’ve heard a variation of this story from my gay male clients. Without doubt, meth use fused with compulsive sex destroys not only lives and relationships, but sexual capability.

Throughout the book, Fawcett describes the effects of meth-sex addiction on the human brain. Early in the book he writes, “Because meth quickly becomes fused with sexual desire and behavior in the brain, re-differentiating the two later becomes a major and sometimes painful task. It is akin to separating two solids once they have chemically bonded.” Later he writes, “The flood of neurotransmitters released by meth, most notably dopamine, quickly depletes the brain, resulting in an ongoing depression. While molecules of other drugs such as cocaine are quickly washed away, meth lingers on the [dopamine] receptor, ultimately destroying it. This results in an especially prolonged period of recovery as the brain literally ‘rewires.’”

If the above statements make the meth-sex fusion sound pretty awful, they should, because it is. The good news is that there is hope for recovery. Gay men (and others) who are addicted to both meth and sex can and often do, with time and effort, heal from this devastating fused addiction. The final third of Fawcett’s book discusses exactly this process, with information on specific skills that can be developed and utilized as part of recovery, dealing with the powerful and uncomfortable emotions that typically underlie and drive addictions (anxiety, shame, loneliness, boredom, etc.), rebuilding relationships with self, loved ones, and community, and (re)establishing a satisfying and rewarding sex life without the use of meth.

In sum, Lust, Men, and Meth is a powerful, interesting, well-written, highly informative, and much needed book. In fact, I believe that the book is a MUST READ for both meth-sex addicts and clinicians who treat substance abuse issues and/or sexual addiction.